Wednesday, August 29, 2012

Bone Density Scans are Over-Recommended in Younger Patients

The American Academy of Family Physicians currently recommends that its members not do bone density scans (dual-emission X-ray absorptiometry - DEXA) to test for bone loss in healthy women who are under the age of 65; for men the age is 70. And yet, many family practice physicians and internists are doing the scans on their younger patients anyway.

The reasons for the disconnect are complex. Many physicians own the X-ray machines used to do bone density scans and therefore they have a financial incentive to recommend a scan. Others simply may not know of the latest recommendations or are taking a defensive medicine approach – the more tests, the better. But it’s not always the physician’s fault; sometimes the patient is aware of the dangers of osteoporosis and asks to be tested, without knowing whether the test is really appropriate for his/her situation.

Knowing when to use medical tests (and when not to) is not always easy. At the very least, it requires a knowledgeable physician and good communication between doctor and patient.

On the flip side, there are indications that bone density scans are being under-utilized in older patients; the ones who actually need them. In recent years there has been a decline in bone density scans under Medicare due to cuts in Medicare Part B reimbursements.

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